Thank you for subscribing to the Global Health Update from Rx for Survival — A Global Health Challenge. In this issue, we examine the impact of oral rehydration therapy (or ORT) on the health of people around the world. This issue is explored more fully in the series' third program, Delivering the Goods (airing on PBS November 2 at 9 p.m. — check local listings).

In recent days, many Americans have been shocked to see the devastation caused by Hurricane Katrina. As emergency personnel continue to rescue those stranded in their homes, lack of clean water in parts of Louisiana and Mississippi is a grave concern.

Clean water is a necessity for life — it keeps us healthy, hydrated and safe from infectious disease. What Americans are now seeing on the news is a crisis that's tackled every day in the developing world. In impoverished countries, approximately one billion people, many of them children, do not have access to clean drinking water. And about 2.6 billion people lack sanitary waste facilities. When bacteria in contaminated drinking water are swallowed, they multiply in the intestine and release toxins — this causes vomiting and diarrhea, leading the body to lose large amounts of fluid and salts. Severe cases can result in death, especially among vulnerable infants and young children.

Since our bodies are about two-thirds water, the dehydration associated with diarrhea causes an estimated 1.8 million deaths worldwide. Scientists working in Bangladesh in the early 1970s learned that a solution of sugar, combined with salt and water — taken orally — could prevent deaths from dehydration. Since intravenous rehydration was not available in many poor settings, oral rehydration therapy (ORT) was to become one of the most effective ways to treat diarrhea.

ORT is a simple, low cost and effective treatment that involves the use of oral rehydration solution — a mixture of salt, sugar and clean water — and continued feeding. Mothers around the world were taught to prepare a home-made solution to keep their children hydrated, to use UNICEF oral rehydration packets dissolved in water, or, if they could afford it, to purchase a commercial product like Pedialyte. Between 1980 and 2000, ORT treatment decreased the number of deaths among children under five due to diarrhea by 60%.

Oral rehydration therapy is considered one of the greatest public health breakthroughs of the 20th century. Families can also help to prevent illness by disposing of waste safely, and by washing their hands after using the toilet, before preparing meals and feeding children.

Rx for Survival was also mentioned in the August 1st issue of People magazine. In a sidebar about Brad Pitt's new ventures, his narration of the series was touched upon.

Broadcast News and Updates

The PBS documentary series Rx for Survival — A Global Health Challenge, will air over three nights — November 1-3 from 9-11pm on PBS (check local listings). Each of the six episodes underscores the visible and often invisible role public health plays in our lives and in the stability of nations. Personal stories throughout the six programs bring health to life. Be sure to tune in:

Monday, November 1

Disease Warriors, 9:00 P.M.
Vaccinators mobilize millions of children in India in the effort to eradicate polio as part of a worldwide effort to rid the planet of this relentless crippler once and for all.

Rise of the Superbugs, 10:00 P.M.
Healthcare workers in Lima, Peru, fight a dangerous drug-resistant strain of tuberculosis that is already affecting patients in the developing world and worrying Western health officials that it could become more widespread.

Tuesday, November 2

Delivering the Goods, 9:00 P.M.
Doctors and aid organizations fight to help the world's forgotten refugees, and women in Bangladesh undertake a revolutionary healthcare program that is transforming this once health-poor country.

Deadly Messengers, 10:00 P.M.
Mosquitoes and other insects carry many of the world's most dangerous diseases across borders. Scientists and health officials struggle to contain these deadly vectors.

Wednesday, November 3

Back to the Basics, 9:00 P.M.
The building blocks of good health, clean water, and nutrition are put to the test in Uganda and Nepal with stunning success.

How Safe Are We? 10:00 P.M.
An innovative HIV/AIDS drug treatment program in Botswana offers a ray of hope in Africa's battle for survival, as scientists and health officials around the world prepare for an emerging pandemic — avian flu.

Brad Pitt has completed the narration for the first four episodes, and recording sessions for the fifth and sixth episodes are being scheduled.

Angelique Kidjo, an African musician and outspoken advocate for the interconnectedness of the world's people, has enthusiastically agreed to be a spokesperson for Rx for Survival. She has produced eight albums, including songs in four languages, and recently performed at Live8. As a UNICEF ambassador, Angelique has traveled to Tanzania, South Africa, Ethiopia and her native country of Benin to see the way that girls are treated there.

Web Site News and Updates

The latest addition to the "Dispatches from the Field" section of the Rx for Survival Web site comes from Sarah Holt, producer, writer, and director of the Rise of the Superbugs episode from the Rx for Survival series.

In her dispatch entitled "Something Truly Ambitious," Ms. Holt describes her moving experience in Peru where she spent time with multi-drug resistant tuberculosis patients. Capturing the work of non-profit group Partners for Health, and their efforts to halt the epidemic, Holt discusses the devastating effects of the illness and the challenges associated with the therapy itself. She focuses on the heartbreaking story of a specific patient, Raquel, mother of a nine-year old boy, as she tries to battle multi-drug resistant TB.

Rx for Child Survival Campaign News and Updates

The American Academy of Pediatricians (AAP) will distribute full-color posters highlighting Rx for Child Survival to 45,000 pediatricians and AAP members in general practices — look for it in your local pediatrician's office.

Our community coalition in Grand Rapids, Michigan — led by WGVU — hosted approximately 8,000 children, parents, grandparents and school groups at its annual "KIDSDAY at the Zoo." The event featured an Rx for Survival booth, which shared hand fans printed with hydration tips and colorful handouts. Stephen Chappell, the event's organizer, reported, "the best thing about our first event is that it demonstrated to our coalition that children and adults alike are receptive and even eager to hear and learn about health issues and preventative measures and/or interventions." Be on the lookout for Rx for Survival events in your community!

The Penguin Press is publishing Rx for Survival: Why We Must Rise to the Global Health Challenge, written by Phil Hilts. The book will be released October 24th and will be accompanied by an online readers' guide — stay tuned for more details.

Global Health Headlines

To help readers grasp how global health affects each one of us, below
are links to global health-related stories currently in the news.

Global Health Hero

Fazle Hasan Abed, founder and chairperson of BRAC (formerly known as the Bangladesh Rural Advancement Committee), has captured international attention for creating what many experts deem to be the most effective non-governmental organization in the world.

Since 1972, BRAC has fought against poverty, disease, child mortality and illiteracy by empowering the rural poor. Abed's first major goal for BRAC was to teach mothers to make oral rehydration solutions to prevent the deaths of their children from diarrheal dehydration. "That involved going to every household in rural Bangladesh, 13 million households, and it took 10 years to do it." BRAC's oral rehydration program helped to reduce infant and child mortality from 258 deaths per thousand to 75 deaths per thousand by teaching mothers to prepare the oral rehydration solutions at home, using a combination of water, molasses sugars and salt.

Today, BRAC is active in more than 68,000 villages, has 4.8 million group members, and runs 31,000 one-room, one-teacher schools. Abed's strategy has always been ambitious: "We thought nationally, worked locally, and looked for inspiration globally."

Read more about this global health hero at http://www.brac.net/chairperson_1.htm — and be sure to watch Delivering the Goods, the third episode of Rx for Survival on PBS November 2 at 9pm (check local listings) for more on Abed and other global health heroes.

Success Stories

Rohima is part of a network of 33,000 trained women shasto shebikas, or grassroots community health workers who make up BRAC, a non-governmental organization funded two decades ago by international donors. She never had the chance to finish primary school, but today she can recognize and treat simple illnesses. After the death of her husband, Rohima (women in Bangladesh frequently use just one name) survived by growing vegetables on a small plot and begging food from neighbors.

In the 1980s, Rohima learned about BRAC's training program for community health workers and signed up; she considers that moment the turning point of her life. Today Rohima monitors the health of 300 households, visiting 15 homes a day, and dispensing advice about nutrition, sanitation and family planning. She teaches mothers to treat their children's diarrheal dehydration by giving them home-made oral rehydration therapy. She can also make preliminary diagnoses of illnesses like tuberculosis, referring her patients to BRAC clinics for final tests and treatment.

Rohima is so respected in the community that she was recently elected to her village council. "When I walk through my village, people stop me all the time. They seek my advice, ask me how I'm doing. I see how things are improving and I feel very happy."

Watch Rohima in action in Delivering the Goods, the third episode of Rx for Survival on PBS November 2 at 9pm (check local listings). For more on the history of BRAC visit http://www.brac.net/history_1.htm

An innovative child care initiative to bring the right care into people's homes by "bundling" health services in a way that best suits family needs is showing significant progress in several West African countries and could save millions of lives in years to come, the head of the United Nations Children's Fund said in a statement released May 16th.

"They have exceeded expectations, and shown us just what can be achieved over a short period of time through sound science using an integrated approach," UNICEF Executive Director Ann M. Veneman said, announcing the early results of the Accelerated Child Survival and Development program, which was initiated in 2002 in some 100 districts within 11 countries in West Africa. After three years of increasing coverage in basic health interventions, UNICEF estimates that child deaths will have dropped by an average of 20 per cent across the 16 districts where the program was fully implemented, and by 10 per cent where it was partially applied.

The program takes the most effective health interventions for children, newborns and pregnant women and bundles them in an integrated, cost-effective package, including immunizing children and pregnant women, delivering life-saving micronutrients, encouraging breastfeeding and supplying oral re-hydration salts to treat diarrhea as well as bed nets for protecting children and women from malaria. The initiative was applied most intensely in 16 districts in Senegal, Mali, Ghana and Benin, where the under-five mortality rate dropped an estimated 25, 21, 17 and 16 per cent respectively. The program focused on districts that were the hardest to reach, often with the highest mortality rates, and proved that significant progress is possible against the odds.

About Rx for Survival

A multi-media project that includes a six-hour PBS television series airing November 1-3, 2005, Rx for Survival — A Global Health Challenge is a co-production of the WGBH/NOVA Science Unit and Vulcan Productions, Inc.

Rx for Child Survival — A Global Health Challenge, a project of the WGBH Educational Foundation and Vulcan Productions, Inc. in collaboration with CARE and Save the Children, and in association with The Global Health Council and UNICEF, urges Americans to get informed and involved in making a difference in the lives of young children around the world.

Major funding for Rx for Survival — A Global Health Challenge is provided by the Bill & Melinda Gates Foundation and The Merck Company Foundation.